Medical schools must keep offering cadaver-based education
I will never forget stepping into the cadaver lab for the first time. As the doors swung open, a sharp, sour wave of formaldehyde hit me and made my stomach churn. I pulled my thin polyester scrub shirt over my nose, but it did little to block the smell, let alone shield me from the bone-chilling temperature. Steel tables surrounded me, each holding a body, and I could see grayish-yellow skin peeking out from beneath the white drapes. Everything about that moment was deeply unsettling.
But as the semester went on, and my knowledge of human anatomy grew, so did my excitement for the cadaver lab. I learned to see beyond the shock of lifeless bodies and appreciate the lessons they offered. Even the smell seemed to gradually fade away.
Next year, however, my medical school will become one of the latest to abandon cadaver-based education, using technology to teach anatomy instead. And I can’t help but wonder: What will be lost when medical students are no longer made to uncomfortably face death to learn from what a real human body can teach?
In recent years, many medical schools, including those of Case Western Reserve University and New York University, have eliminated their cadaver programs. The most popular alternatives include virtual reality, augmented reality, and other 3D visualization tools like the Anatomage Table, which is a life-sized, interactive touchscreen that allows students to perform virtual dissections on digital human bodies. When I studied at Harvard Medical School for my master’s, I had the opportunity to use an Anatomage Table, and simply put, it is nothing like the cadaver lab. The system, whose cost can reach more than $100,000, was tucked behind the coffee shop on the first floor of the medical school library. Yet it didn’t seem much more useful than the free anatomy app I had downloaded on my phone. While the scans were crisper and the images were impressively detailed, the flat screen remained a barrier between me and the body.
In the cadaver lab, the weight of an actual body beneath your inexperienced hands is as real a preparation for the operating room as it gets. You press the tissue between your fingers, noting how each layer responds, where it is fragile versus where it resists. You trace the path of veins and arteries as they snake beside each other before twisting into organs or leading back to the heart. You realize that nothing is color-coded, that what you assumed was a tendon is actually a nerve. And with each cadaver, you discover an illness narrative — the blackened lungs of a chronic smoker, the telltale marks of a hernia repair or hysterectomy, or, if you’re lucky, a case of situs inversus, where the major internal organs of the body are reversed in their positions.
Most importantly, you familiarize yourself with death. You learn to stand in its presence without fear and to see it as an undeniable part of medicine and life. The cadaver lab is an education in touch, in sight, and in presence.
Unfortunately, this experience comes with a complicated and troubling history. For years, the sourcing of cadavers was anything but ethical. In the 18th and 19th centuries, medical schools relied on grave robbers known as “resurrectionists” to supply bodies for dissection. Even as legal donation programs emerged in the 20th century, unethical practices persisted, with unclaimed bodies, prisoners, and institutionalized individuals disproportionately used for medical education without consent. And as recently as the early 1900s, medical students were known to pose for photographs with cadavers, treating them with little respect.
Today, consensual body donation seems to be on the rise, but problems remain. In September 2024, for example, an NBC News investigation revealed that the University of North Texas Health Science Center (UNTHSC) had been receiving unclaimed bodies since 2019, with many of the estimated 2,350 remains obtained over a five-year period having been used to train medical students. Using unclaimed bodies is concerning because these individuals most likely did not consent to body donation, which raises serious ethical concerns. This practice is possible in part because the cadaver market has never been regulated. In fact, there is no federal law in the United States controlling the procurement of cadavers for medical education.
Because the cadaver market functions in an unregulated nature, both nonprofit organizations like medical schools and anatomical donation programs as well as for-profit body brokers have become involved. While nonprofits typically rely on voluntary donations and operate under strict ethical guidelines, for-profit brokers receive donated bodies and then charge research facilities, medical training programs, or device companies for them (to think that donating a body results in a sale, in and of itself, is an ethical calamity). Obtaining a whole-body cadaver today can cost up to $5,000, meaning schools may spend a significant amount every year just to maintain their cadaver-based curriculum.
Medical schools turning away from cadaver-based educations will often cite either the aforementioned ethical concerns or the high costs of maintaining such programs as the driving factor. At my school, in particular, the issue is primarily financial.
I don’t blame the administrators who made the decision. The fault lies with the flawed system that has made cadaver acquisition increasingly expensive and logistically impractical. This longstanding problem had already been limiting the depth of our cadaver experience well before the decision to transition to technology-based alternatives. Because of the high demand and annual cost, acquiring enough cadavers for each student to participate in dissection was simply not feasible. As a result, dissection was not included in our curriculum, and we explored already dissected cadavers instead. It was only a matter of time before the program was phased out entirely.
For these reasons, my support for cadaver-based education isn’t a stubborn defense of “we’ve always done it this way, so why change?” The cadaver-based educational system should change, to continue becoming more ethical, maintainable, and sensitized. And I truly believe it can happen because medicine is about problem-solving.
Firstly, Congress should pass legislation to strictly regulate the handling of donated bodies and dismantle the for-profit cadaver market. To date, the only federal law that provides a framework for body donation is the Uniform Anatomical Gift Act (UAGA), which was first passed in 1968. It allows individuals aged 18 years and older to donate their bodies for the purposes of transplantation, medical education, or research. While the UAGA has been adopted by all 50 states, and seems to control the donation side of things, it doesn’t adequately address the handling of donated bodies. Thus, the regulation of nontransplant anatomical donations is left up to states, which has created a fragmented system that has allowed for the creation of for-profit businesses and lax ethical guidelines. For this reason, the use of unclaimed bodies by UNTHSC does not technically violate existing federal or Texas state laws. The Texas Health and Safety Code Chapter 691 outlines that if a body remains unclaimed for burial for 48 hours after a relative has been notified, it can be delivered to the Anatomical Board of the State of Texas where it may then be used for medical education and research purposes. A coordinated federal effort to centralize oversight, standardize ethical practices, and eliminate commercial exploitation would ensure that cadaver distribution remains under accountable control.
Secondly, funding for cadaver-based education should be prioritized in both medical school budgets and federal allocations. An increase in the amount of grants, subsidies, or institutional partnerships could offset costs, making it feasible for schools to maintain high-quality anatomical education.
Finally, while respect for cadavers by students and institutions has come a long way in our society, there’s still room for growth. One part of my curriculum I appreciated was our ethics course, where we spent several sessions exploring questions about organ and body donation that often had no clear answers. Discussions like these push medical students like me, who are privileged enough to experience the cadaver lab, to think critically about the system I benefit from and find creative ways to improve it. In Taiwan, institutions have already started implementing solutions such as having students meet with donors’ families or write poems and letters of gratitude to their “silent mentors.” At the University of Singapore, this approach has significantly increased body donations, as public trust seems to have deepened. U.S. medical schools might consider such an initiative, which might increase students’ empathy and ultimately increase the supply of cadavers and ultimately lower the financial burden of cadaver-based education.
Until we reach a day where technology can truly replicate what cadaver dissection can do for medical students, it should be used to supplement dissection, allowing students to visualize complex structures in libraries while studying for exams or before engaging with real tissue. As a scientist, I certainly advocate for the continued development of technological advancements in this field. However, technology can only take us so far for now, so let’s use it to enhance cadaver-based education instead of using it to dehumanize the human body.
I will forever be grateful for my time in the cadaver lab. I remember a day where we received a new donor, and my group asked if we could watch our professor remove the body from its bag. I was surprised by how comfortable I was, just a few sessions into the semester. The cadaver’s skin was still unpierced, and their eyes were open. Coming face-to-face with a body in that raw state was one of the most powerful moments of my first year in medical school. It taught me reverence and the gravity of what it means to choose this path in health care. I can only hope this profession continues to fight for that experience — for the future doctors who need to learn not just from books or screens, but from the deaths of those who chose to teach us in the most selfless way possible.
Nadir Al-Saidi is a first-year student at Central Michigan University College of Medicine and has a master’s in media, medicine, and health from Harvard Medical School.
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